Session Descriptions
Saturday Keynote: Pediatric Cardiology Emergencies: EMS Can Make a Difference (Aisha Frazier, MD)
Compared with adults, cardiac emergencies are infrequent in children and clinical presentation is often quite variable. In adults, cardiac emergencies are most commonly related to complications of coronary artery disease; however, in pediatric cases, the coronaries are only rarely the underlying problem. Pediatric cardiac emergencies comprise a range of pathology including but not limited to undiagnosed congenital heart disease in the infant; complications of palliated congenital heart disease in children; arrhythmias related to underlying cardiac pathology in the teenager and acquired heart disease. The emergency room physician and pediatric intensivist will usually be the first and second lines of care for pediatric cardiac emergencies and thus it is imperative that they have knowledge of the diverse presentations of cardiac disease in order to increase the likelihood of delivering early appropriate therapy and referral. The objective of this review is to outline cardiac emergencies in the pediatric population and contrast the presentation with adults.
Sunday Keynote: Tomorrow's Strategies Today - Implementing the Latest Developments in Resuscitation Science, Why Wait Until 2015? ( John Freese, MD)
It has been almost a year since the latest resuscitation guidelines were released by the American Heart Association, and many of our systems are just finishing the process of implementing those changes. But should we wait another four years before we change again? The science that will become the 2015 guidelines is being published today, and the potential of that science to save lives should not have to wait. What new technologies are available for 12-lead interpretation? Do CPR feedback devices improve care for all levels of provider? Are the latest AEDs any different than the ones we have been using? Is there value to initiating therapeutic hypothermia during the arrest? Are the “established” termination of resuscitation rules still valid? STEMIs, cardiac arrests, LVADs – should any cardiac patient go just to the “nearest ED?” Less drugs, more drugs or new drugs – what’s next for ACLS? Which devices are worth using and which devices are useless? We will discuss these topics and more, review the cutting edge of cardiac care and suggest things that your systems can do today to improve prehospital medicine in your community.
The Signs of Child Abuse (Wendy Gladstone, MD)
Have you ever responded to the local grocery store for a two-year old patient who fell out of his mother’s arms? You were pretty sure it was an accident, so you did not submit a report for suspected abuse. This session is intended to provide EMS providers and school nurses with more information on recognizing, evaluating, and reporting suspected child abuse. By the end of this session you should be able to recognize situations in which child abuse or neglect should be suspected. In addition, you will learn techniques to communicate with children and caregivers about the possibility of maltreatment and you will learn how to report suspected abuse or neglect.
Just Breathe (Carrie Patel, RN)
During this session, we will review the anatomy of pediatric and neonatal airways and discuss common pediatric airway emergencies. This course is designed to take the fear out of managing pediatric airways in the field for BLS and ALS providers.
Congential Emergencies (Joan Stoler, MD)
You’re not too worried after you’re dispatched to the local playground for a 13-year-old with a possible broken arm until you arrive on scene and the school nurse tells you that the 13-year-old has osteogenesis. Are you still going to splint the same way? Is your assessment going to be the same? During this session, you will learn about some of the most common congenital disorders that result in 911 calls and how you can best treat these patients. This session will focus on the physiology, assessment, and pre-hospital treatment of these special patients.
The ABC's and 123's of Pediatric Trauma (Heidi Almodovar, RNP)
The goals of prehospital management of the critically injured child include rapid assessment and treatment of life-threatening conditions followed by immediate transport to a hospital.
During the initial assessment, life-threatening conditions are identified and simultaneous management is begun. Once the patient is deemed stable, the provider continues with an in-depth secondary assessment. This presentation will:
- Identify the key components of the primary and secondary survey
- Describe treatment priorities in the resuscitation phase of trauma
- Discuss common pediatric traumatic injuries through case based scenarios
Objectives: After attending this presentation the participant will: Have knowledge of an in-depth pediatric primary and secondary trauma survey; Understand the principles of evaluation and stabilization of the pediatric trauma patient; Recognize that pediatric trauma care differs from that of adults
SIDS (Thomas Andrew, MD)
Sudden unexpected infant death (SUID) presents special challenges to first responders, death investigators and forensic pathologists. This presentation will offer participants a precise definition of what may be considered sudden infant death syndrome (SIDS) and an explanation as to why this is becoming a much less frequent diagnosis. Risk factors for SIDS, the integral role of sleep environment in infant death, the public health conundrum of bed-sharing and the medical differential diagnosis of SUID will also be discussed.
Chest Pain Assessment (Tony Pellegrino, PA-C)
Assessing patients with chest pain requires an adequate history and examination, often difficult in the confines of the EMS environment. The target audience is both the BLS and ALS providers. The objectives of this course will be to: understand the causes of chest pain; have a systematic approach to assessing a patient presenting with chest pain; understand the sequence of investigations in a patient with chest pain; recognize normal and abnormal findings; formation of a differential diagnosis; document clinical findings.
PediaSIM (Hildi Orkin, NREMT-P)
Medical Education Technologies, Inc. (METI) is a company committed to developing learning tools that impact the education of our future doctors, nurses, first responders and military medics. They are an education company first, and are committed to providing technologically advanced learning tools. PediaSIM, by METI, plays an important role in ensuring that a learner's first real exposure to the complexities and nuances of treating a critically ill child takes place when the stakes aren't high and the dangers aren't real. Come run scenarios using the METI high fidelity human patient simulator, PediaSIM. The PediaSIM simulator breathes, blinks, has pupil response, bleeds, and even talks. During this 1.5 hour seminar that will run in each of the time slots, participants will get the chance to work as a team with this top of the line simulator to treat a variety of pediatric emergency medical problems.
Pediatric Dysrhythmias (Aisha Frazier, MD)
Pediatric arrhythmias are less common than among adults, but are equally as important for the emergency medical team to be able to recognize the abnormal rhythm, respond immediately and treat appropriately. This session will review the diagnosis and management of the most common pediatric dysrhythmias in children with structurally normal hearts, as well as with congenital and acquired heart disease.
Pediatric Resuscitation (John Freese, MD)
Attempting to resuscitate a respiratory or cardiac arrest patient can be stressful, but when that patient is a child it becomes a much different moment. Pediatric resuscitations are some of the more stressing calls that EMS providers will face in their career, and being prepared for those calls can mean the difference between life and death for the patient - and between an attitude of knowing that the best possible care was given and the potential "what if" scenario for the providers. What can you do to better prepare yourself for such a call? What do the latest resuscitation Guidelines recommend for these patients? And are there things that go beyond the Guidelines that you should be considering for your system. We will attempt to address these questions and more in discussing our smallest patients in their most critical hour of need.
Evaluation of Acute Chest Pain, A Cardiologist's Approach (Todd Perlstein, MD)
This session will focus on the patient with acute chest pain, beginning with historical features that point to a particular cause, then discussing vital signs and the cardiopulmonary physical examination, and finally reviewing EKG findings relevant to the evaluation of chest pain. Specific etiologies of chest pain to be discussed are acute coronary syndrome/myocardial infarction, pulmonary embolism, aortic dissection, pericarditis/tamponade, costochondritis, and esophageal spasm. At the end of the session the attendee will have developed an approach to the evaluation of acute chest pain in the field.
Sepsis in Kids (Gitte Larsen, MD & Nancy Mecham, RN)
Unrecognized and undertreated septic shock increases morbidity and mortality for children. Septic shock in children differs from adults in that it is defined as sepsis and cardiovascular organ dysfunction, not necessarily with hypotension. Cases of unrecognized and undertreated septic shock in our emergency department (ED) were reviewed with a focus on increased recognition at triage and more aggressive treatment once recognized. We developed an ED septic shock protocol and care guideline to improve recognition beginning at triage and have continued to work on the program for the past 5 years. The greatest gains in care have included more complete recording of triage vital signs, timely fluid resuscitation and antibiotic administration. We will discuss the successes and pitfalls of guideline implementation, some techniques for maintaining the gains, and the results of our program.
Sick Kids - Infectious Diseases (Matthew Greenberg, MD)
Medical emergencies are far less common in children and adolescents than in adults. However, infectious diseases are common in this age group, and can be life-threatening. These include RSV, croup, pneumonia, meningitis, and sepsis. Early recognition of these infections increases the possibility of rapid treatment and reduces morbidity and mortality. At the end of this session you will have familiarity with these general disease processes (sepsis will be covered in a different session). You will know some basic key findings that help distinguish these more significant disease processes from more common and less harmful illnesses of children. We will discuss early management and key details to relay to the ED. Extra attention will be placed on the rare yet devastating meningococcemia.
EMS Delivery in Bush Alaska (Matthew Greenberg, MD)
Ever wonder about the logistics of getting a sick patient with appendicitis from a remote subarctic island to definitive surgical care more than 500 miles away? How does a team care for a neonate in respiratory distress in the middle of a blizzard when there are no roads to the nearest hospital? In New England, we are all familiar with “Rural” and the phrase “you can’t get there from here.” Consider, however, a population of 30,000 living in harsh subarctic conditions in a frozen swamp the size of the state of Oregon. This is the reality of the Yukon-Kuskokwim Delta. Providing EMS in remote Alaska requires creative thinking and the willingness to try to provide first-world care in a third-world setting.
This session will provide a primarily visual tour of the EMS system in the remote Yukon-Kuskokwim Delta of Southwest Alaska. The learner will become acquainted with the harsh living conditions and the remote geography that challenge the EMS system in all aspects. The learner will become familiar with the system of village clinics, health aides, local fire departments and medevac services. Further, the learner will be introduced to the Yupik Eskimos that call this region home. This information will be presented from the first hand perspective of the lecturer, who spent the last 5 years intimately involved in this system.
Developing Training Programs for your Service (Chris Lemelin, MPH, EMT-I)
This session will offer one method of many for developing and implementing a comprehensive educational training program for your EMS service. This discussion will be based around what EMS providers wish to learn more about and the how to implement affordable, realistic trainings for the service. Tips and tricks will be shared and you will leave the session with a better understanding of how to develop and implement training programs that will not only benefit your service’s
EMS providers, but also the communities you serve.
New Hampshire Marine Patrol (Lieutenant Tim Dunleavy )
New Hampshire has beautiful, numerous bodies of water that we enjoy every day. But when something goes wrong, water can be one of the most dangerous situations you encounter. NH Marine Patrol is ultimately responsible for ensuring safe public waters for everyone to enjoy. In addition to enforcing boating laws, NH Marine Patrol is also responsible for investigating drownings and boating accidents. During this session, you will learn about the role of NH Marine Patrol during water related emergencies. This session will discuss the resources that NH Marine Patrol has, how to utilize them appropriately, what EMS and Fire Departments can expect from Marine Patrol, and what Marine Patrol expects from EMS/Fire
Transporting Non Critical Pediatric Patients (Cindy Tuttle & Vincent Curro)
Co-presenters Cindy Tuttle, RN, CPST-I and Vinny Curro EMT-B, CPST-I, will be presenting an overview of the new curriculum, Improving Occupant Protection for Non-critical Pediatric Patients in Ambulances: A Training Curriculum for EMS Personnel as recently released by the National Highway Traffic Safety Agency, in cooperation with Dr. Marilyn Bull, the National Center for the Safe Transportation of Children with Special Healthcare Needs, Kohl’s Center for Safe Transportation of Children, The Automotive Safety Program at Riley Hospital and Indiana University School of Medicine. They will discuss how this new curriculum works in conjunction with the current State Protocols for Pediatric patients. Along with the curriculum presentation, the presenters will have available and demonstrate, alternative sources of restraints available for EMS personnel to use to transport non critical pediatric patients.
Fighting Childhood Obesity in Schools (Kim Truesdale & Charae Spuler)
5210 Steps Up! Is an initiative which began as a coalition of local organization and health care advocates committed to promoting healthy choices in nutrition and physical activity known as Step It Up Seacoast. This coordinated effort to fight childhood obesity focusing on six domains: Healthcare, Schools, After School Programs, Early Childhood, Workplace, and Community Centers. This session will discuss ways to implement wellness programs in communities and schools. In addition, this session will highlight risk factors, assessment and treatment considerations specific to pediatric patients who are overweight.
Diabetic Cardiac Emergenies (Mary Katherine Lockwood)
Diabetes is a major risk factor on cardiovascular disease. Diabetes and cardiac care will cover the etiology of type I and type II diabetes with an emphasis on the impact of disease on general health. Short term effects of hypo and hyperglycemia on cardiac rhythms and cardiac status will be discussed as well as the long term complications of diabetes to both the micro and microvasculature and the role of these complications in cardiac health.
Better Cardiac Arrest Management (Jim Suozzi)
You’ve heard all about the new CPR (now its CAB instead of CPR) and impedance threshold devices, but how do you manage and integrate all of these pieces to produce better patient outcomes? This session will review what we have learned about how to improve cardiac arrest outcomes, including use of new modalities, and will help you implement good cardiac arrest management in the field.
Focus EMS 2011 has been approved for Maine, New Hampshire, Massachusetts and Vermont CEUs. To learn about continuing education and Focus EMS click here.
